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Articles 1 - 30 of 152
Full-Text Articles in Medicine and Health Sciences
Physical Activity Improves Depressive Symptoms In Older Adults, Karen Lee Fahey
Physical Activity Improves Depressive Symptoms In Older Adults, Karen Lee Fahey
Walden Dissertations and Doctoral Studies
Engaging in physical activity can help older adults to take part in community activities, maintain relationships, and initiate new friendships, thus preventing loneliness and depression. The purpose of this quality improvement (QI) project was to evaluate whether participation in physical activity improved depressive symptoms in 15 older adults at a local senior center. Pender’s health promotion model was used to determine nursing and behavioral science views on components that affect health behavior. The Exercise Benefit/Barrier Scale (EBBS) survey was evaluated before implementation of the walking program to measure the benefits of and barriers to exercise. The EBBS results showed that …
Health Care Clinicians' Compliance With Conducting Spiritual Assessments And Providing Spiritual Care To Infertile Women, Lesa Miller
Walden Dissertations and Doctoral Studies
Infertility is a disease that can cause psychological impairments in women, and the inability to achieve motherhood brings about cultural and social stigma. Spirituality is a protective element that may provide consolation to women experiencing infertility, yet the literature has shown that few clinicians conduct spirituality assessments or provide spiritual care to patients. The objectives of this scholarly project were to conduct an assessment to determine the needs of health care clinicians in regard to spirituality and spiritual patient care and to develop an educational module based on identified knowledge deficits. Guided by the knowledge-to-action cycle, a needs assessment was …
Managing Acute Pain In Postoperative Surgical Patients, Sabrina Gregory
Managing Acute Pain In Postoperative Surgical Patients, Sabrina Gregory
Walden Dissertations and Doctoral Studies
Every year, millions of Americans suffer from either chronic or acute pain that results in tremendous healthcare cost, rehabilitation, and loss of work productivity. Pain is an unpleasant sensation associated with sensory and emotional experiences that can cause potential or actual tissue damage. One plausible solution to managing pain is the use of nonpharmacological modalities such as guided imagery. The purpose of this project was to determine if there was a difference in pain scores following pharmacological interventions and the use of guided imagery among postoperative same day surgical patients. Guided imagery is a nonpharmacological modality that uses pictures, music, …
Implementation Of A Nurse Practitioner Residency Program In Critical Access Hospitals, Anna Ngwisah Bolima
Implementation Of A Nurse Practitioner Residency Program In Critical Access Hospitals, Anna Ngwisah Bolima
Walden Dissertations and Doctoral Studies
Access to health care in rural communities is challenged by workforce shortages. Nurse practitioners (NPs) have been filling the gap created by physician migration into specialty areas. Flex hospital legislation allows critical access hospitals (CAHs) to staff the emergency department with NPs without on-site physicians. NP education often lacks emergency and trauma curriculum, resulting in gaps in practice expectations and significant role transition stress and turnover. The purpose of this project was to construct from the scholarly literature a transition-to-practice residency program to support NP's in providing emergency department care in the CAH. The limbo to legitimacy theory guided the …
Strategies To Mitigate Nurse Turnover In Eastern And Northern Virginia, Fred E. Echoles
Strategies To Mitigate Nurse Turnover In Eastern And Northern Virginia, Fred E. Echoles
Walden Dissertations and Doctoral Studies
Registered nurses leaving the workplace are estimated to cost healthcare organizations and society between $1.4 and $2.1 billion annually. The purpose of this multiple case study was to explore what strategies leaders of healthcare organizations from the Eastern and Northern regions of Virginia can use to mitigate the effects of nurse turnover and its cost to the organization. The target population consisted of 8 RNs who experienced turnover during their nursing careers. The conceptual framework for this study was Herzberg's dual-factor theory. Face-to-face semistructured interviews were conducted and publically available documents were garnered. Thematic reduction of participants' interviews, coupled with …
An Evidence-Based Asthma Management Plan For The Pediatric Practice Setting, Foroogh Narmani-Mohammadi
An Evidence-Based Asthma Management Plan For The Pediatric Practice Setting, Foroogh Narmani-Mohammadi
Walden Dissertations and Doctoral Studies
Asthma is the most common chronic disease in childhood. Education directed toward asthma self-management is vital and emphasizes patient participation in symptom monitoring and control. The practice problem addressed in this quality improvement project was the lack of an asthma management plan in the pediatric setting for which the project was developed. The purpose of the project was to develop an evidence-based asthma initiative consisting of a staff education curriculum with a pretest/posttest and a patient self-management component. Using a team approach, Rosswurm and Larrabee's conceptual model served as the practice framework to guide the development of the project. Two …
Improving Colorectal Cancer Screening In Primary Care, Jenerie Reniedo Navarrete-Pak
Improving Colorectal Cancer Screening In Primary Care, Jenerie Reniedo Navarrete-Pak
Walden Dissertations and Doctoral Studies
Despite indications that colorectal cancer (CRC) screening strategies can decrease mortality and morbidity, screening rates among veterans remains to be low. In the Veterans Affairs (VA), the performance measure for CRC screening is lower than the national standard. This quality improvement (QI) project evaluated the effect of a team-based approach, effective electronic information structures, and the provision of education to nurses and patients in increasing CRC screening rate in primary care from 77% to 85%. CRC screening data were retrospectively collected prior to the start of the project and then compared to screening data 3 months after project implementation. The …
Development Of A Patient And Family Educational Document Following Cancer Treatment, Debbie Slipkovich
Development Of A Patient And Family Educational Document Following Cancer Treatment, Debbie Slipkovich
Walden Dissertations and Doctoral Studies
New pharmacological interventions for oncology patients have resulted in longer lifespans after treatment completion and a large population of cancer survivors in communities. When patients complete treatment regimens for cancer, they leave the oncology practice with minimal knowledge of community resources that may assist them during this time of transition. These patients may not interact with care providers again until they return for a surveillance appointment in the future. Guided by Bandura's social cognitive theory, this project's aim was to develop a community-specific brochure that described the variety of services available to oncology patients and their families. The practice-focused question …
Increasing Seasonal Influenza Vaccine Rates In A Black Inner City Population, Barbara E. Beckford
Increasing Seasonal Influenza Vaccine Rates In A Black Inner City Population, Barbara E. Beckford
Walden Dissertations and Doctoral Studies
The seasonal influenza (flu) vaccine has been shown to prevent flu outbreaks that can cause debilitating effects on the body and even death. Underserved members of Black communities are more likely to refuse the flu vaccine than are persons of other ethnicities. The purpose of the project was to determine from a needs assessment the reasons for flu vaccine refusal in the Black population of an inner city clinic in order to develop tailored communication and nursing actions that promote awareness of the flu vaccine's importance and safety. The health belief model constructs (perceived susceptibility, perceived severity, perceived benefits, and …
Making A Difference: Evidence Based Palliative Care Education For Neonatal Nurses, Sherry Elaine Pye
Making A Difference: Evidence Based Palliative Care Education For Neonatal Nurses, Sherry Elaine Pye
Walden Dissertations and Doctoral Studies
The death of a neonate is a life-changing and tragic experience for the individuals involved in the final moments of the infant's life. As the frontline provider in this clinical scenario, the bedside nurse supports the patient and family through their individual journey of loss. If the nurse does not possess the palliative care educational background and communication skills to support this unique care delivery process, the journey of death can evolve into a particularly negative experience for the parents and the nurse. This specific delivery of care concern was identified and gleaned from a parental bereavement exit interview after …
Practice Preparedness In New Graduates: Exploring The Education-Practice Gap, Wendy L. Batch-Wilson
Practice Preparedness In New Graduates: Exploring The Education-Practice Gap, Wendy L. Batch-Wilson
Walden Dissertations and Doctoral Studies
As newly licensed registered nurses enter their first nursing role, their perceived preparation for practice may vary. This descriptive study addressed the education-practice gap that exists as nurses transition into nursing practice. The use of Benner's skill acquisition model offers a structure for connecting theory to practice. New graduate nurses responded to the Casey-Fink Graduate Nurse Experience Survey-© to identify gaps in preparedness for novice practice. A convenience sample of nurses within the first 12 months of hire (n = 35) was sent the survey link by educators from the chosen sites. Anonymity was maintained with 18 total responses and …
Knowledge, Attitudes, And Beliefs About Preconception Care Among American Adolescent Females, Lynette Collins Collins
Knowledge, Attitudes, And Beliefs About Preconception Care Among American Adolescent Females, Lynette Collins Collins
Walden Dissertations and Doctoral Studies
Despite an initiative to provide preconception care (PCC) and reproductive life planning (RLP) for all women of childbearing age, many women, especially those with low incomes, are not receiving it. As a result, there continues to be a high rate of infant morbidity and mortality in this population. Furthermore, low income adolescent females have not been adequately studied regarding this phenomenon. The purpose of this phenomenological study was to explore low income adolescent females' knowledge, attitudes, and beliefs about PCC and RLP in order to serve them more effectively. Five low income adolescent females, aged 18 to 21, were recruited …
Orientation Of Nurses Transitioning Into Hospital Specialty Units, Mary Laly Chacko
Orientation Of Nurses Transitioning Into Hospital Specialty Units, Mary Laly Chacko
Walden Dissertations and Doctoral Studies
Competency-based nurse orientation programs focus on the new nursing graduate and experienced nurse employees' ability to perform skills necessary in a new work setting. The purpose of this project was to develop a learner-focused and competency-based orientation program for new nursing employees at a large urban hospital to enhance patient safety and nurse retention. The Johns Hopkins nursing evidence-based practice model and guideline were used in the selection of articles with higher levels of evidence and research quality for the critical appraisal of literature in support of the program development. The best practices for nursing orientation content and delivery for …
Effect Of Healthy Food Demonstration On Minority Women's Dietary Habits In San Antonio, Texas, Staria Hudson Black
Effect Of Healthy Food Demonstration On Minority Women's Dietary Habits In San Antonio, Texas, Staria Hudson Black
Walden Dissertations and Doctoral Studies
Obesity has become a global epidemic. Healthcare cost continues to increase due to co-morbidities such as diabetes, hypertension, and coronary artery disease associated with obesity. The purpose of this project was to examine whether teaching nutritious food choices to obese African American and Hispanic females in healthy cooking demonstrations would have an effect on their dietary behavior. The holistic self-care model was used to develop healthy strategies for weight loss. The model guided the development of nutritional support, exercise, and spiritual strategies for weight reduction. African American and Hispanic females between the ages of 25 to 64 were solicited from …
Improving Pain Management For Hospitalized Patients, Ronda Sweet
Improving Pain Management For Hospitalized Patients, Ronda Sweet
Walden Dissertations and Doctoral Studies
Uncontrolled pain has proven effects on both physiological and psychological responses of hospitalized patients. These incapacitating sequelae most often negatively impact patient outcomes resulting in unnecessary suffering and prolong hospitalizations. First line nurses often have preconceived notions about a patient's pain without developing an individualized patient context that considers appropriate pain management knowledge translated from best practice standards. Guided by Bandura's social learning theory and Lippitt's change theory, the purpose of this quality improvement project was to determine if use of the Curriculum Outline on Pain for Nursing from the International Association for the Study of Pain (IASP) improved nursing …
Nurses' Occupational Trauma Exposure, Resilience, And Coping Education, Sherry Lynn Jones
Nurses' Occupational Trauma Exposure, Resilience, And Coping Education, Sherry Lynn Jones
Walden Dissertations and Doctoral Studies
Nursing education courses and professional development (PD) do not include coping and resilience training for registered nurses (RNs) who work in emergency departments (EDs). Exposure to traumatic events, death, and dying may lead to health issues, substance abuse, stress symptoms, nursing staff turnover, and compassion fatigue among ED RNs. Without training, the pattern of adverse outcomes may continue. The purpose of this study was to explore ED RNs' experiences with occupational traumatic stress (OTS), and their recommendations for change to nursing PD programs, using a qualitative bounded intrinsic case study. The conceptual framework for this study included social learning and …
Assessing Nurse Manager Competencies In A Military Hospital, Ruby O. Anderson
Assessing Nurse Manager Competencies In A Military Hospital, Ruby O. Anderson
Walden Dissertations and Doctoral Studies
Military health care organizations need competent frontline managers with knowledge and skills to manage health care complexity and ensure evidence-based practice. With systematic, planned turn over of military managers, more civilian managers are needed to fill permanent positions in military hospitals. The purpose of this project was to provide a better understanding of the competencies perceived by nurse managers at a military medical center and whether they differed by military or civilian status. The American Organization of Nurse Executives competency model and framework provided the theoretical framework for the project. The design was nonexperimental, with an observational, descriptive, cross-sectional approach. …
Using Sbar To Decrease Transfers From The Long-Term Care To The Emergency Room, Phyllis Marie Bowers Garrett
Using Sbar To Decrease Transfers From The Long-Term Care To The Emergency Room, Phyllis Marie Bowers Garrett
Walden Dissertations and Doctoral Studies
Care of the elderly, long-term care resident in the emergency department is an issue of importance because of the overall impact on healthcare costs, potential for negative outcomes for the resident, and the loss of revenue. The purpose of this project was to decrease avoidable transfer of residents to the Emergency Department. Using the Antecedent, Target, Measurement logic model, poor quality assessment data was deemed the antecedent of the avoidable transfer. The goal of the project was the implementation of a standardized process of assessment that would have decreased avoidable transfer of the resident. The project would have involved training …
Nurses' Experiences Transitioning From Staff Nurse To Management In A Community Hospital, Jennifer Sylvia Buffenbarger
Nurses' Experiences Transitioning From Staff Nurse To Management In A Community Hospital, Jennifer Sylvia Buffenbarger
Walden Dissertations and Doctoral Studies
This project study addressed the problem of frequent turnover of nurse managers at a Northeastern community hospital. The lack of retention of nurse managers has led to attenuated support for the nursing staff who continued to hold the front line in patient care. The purpose of this qualitative bounded case study was to explore nurse managers' experiences with turnover in order to identify strategies for enhancing retention. Work empowerment and servant leadership theories served as the frameworks for the study. Research questions focused on nurse managers' perceptions of empowerment and servant leadership characteristics that were important in decisions to assume …
Characteristics Of The Informal Caregiver: An Integrative Literature Review, Jonanna R. Bryant
Characteristics Of The Informal Caregiver: An Integrative Literature Review, Jonanna R. Bryant
Walden Dissertations and Doctoral Studies
The needs of the informal caregiver can be difficult to determine apart from those related to caring for the terminally ill loved one. Often, informal caregivers' individual needs are lost because of their day-to-day responsibility and care of their terminally ill loved one. The purpose of this project was to discover the characteristics of informal caregivers of the terminally ill. An integrated literature review was conducted using the Fineout-Overhalt, Melnyk, Stillwell, and Williamson's (2010) analytical approach to reviewing the evidence. The approach consisted of 7 levels for evaluating the hierachy of evidence. Inclusion criteria were studies limited from January 2004 …
Decreasing Surgical Site Infections In Vascular Surgery Patients, Charlene Knight Little
Decreasing Surgical Site Infections In Vascular Surgery Patients, Charlene Knight Little
Walden Dissertations and Doctoral Studies
Postoperative surgical site infections are common complications in the operating room. Infections prolong hospital stays, heighten costs, and increase morbidity and mortality. The purpose of this evidence-based quality improvement project was to develop policy, program, and practice guidelines to prevent surgical site infections in vascular surgery patients. Rosswurm and Larrabee's change model was used to develop materials using the best evidence for the recommended practice changes. The Plan, Do, Check, Act model was selected to guide quality improvement. The project goal was to decrease the surgical site infection rate to below the national average. Products of the project include policy, …
Development Of A Teach-Back Educational Module For Heart Failure Discharge Teaching, Marissa Blair Jamarik
Development Of A Teach-Back Educational Module For Heart Failure Discharge Teaching, Marissa Blair Jamarik
Walden Dissertations and Doctoral Studies
Heart failure (HF) readmissions create a financial burden for healthcare nationwide and speak to the lack of effective discharge preparation for patients to be successful with self-care at home. The 183-bed hospital where this DNP quality initiative will take place currently reports an observed-over-expected (O/E) readmission rate for HF patients (Centers for Medicare and Medicaid [CMS]). Core measures on HF developed by the Joint Commission and the Centers for Medicare and Medicaid Services do not appear to be enough to ensure successful transitions of care from hospital to home. Guided by the LOGIC model, the purpose of this quality improvement …
Tools That Measure Caring: A Systematic Literature Review Of The Impact Of Caring, Jennifer Drake
Tools That Measure Caring: A Systematic Literature Review Of The Impact Of Caring, Jennifer Drake
Walden Dissertations and Doctoral Studies
Technology and the complexity of the patient care can take the nurse's attention away from caring for the patient to caring for the technology. The purpose of this systematic review was to gather evidence from the literature on tools for measuring caring and the outcomes in order to make that body of knowledge easily accessible to the direct care nurse for implementation. Jean Watson's theory of human caring 'the theoretical framework that guided and informed this DNP project' focuses on human caring processes and experiences. It assumes that effective caring promotes health and outcomes of the nurse and patient. By …
Moving Evidence Into Practice: Early Sepsis Identification And Timely Intervention In The Emergency Department (Project Code Sepsis), Jonjon Macalintal
Moving Evidence Into Practice: Early Sepsis Identification And Timely Intervention In The Emergency Department (Project Code Sepsis), Jonjon Macalintal
Walden Dissertations and Doctoral Studies
Sepsis is the leading cause of death among hospitalized patients in the United States, is responsible for more than 200,000 deaths annually, and has as high as a 50% mortality rate. Sepsis requires prompt identification so that early goal-directed therapy can be instituted to lead to better outcomes. The purpose of this quality improvement project was to determine if implementing an evidence-based identification and intervention program, Project Code Sepsis, in the emergency department can increase the number of patients who receive antibiotics within the first hour of triage and decrease the length of hospital stay. Specifically, the primary project goals …
An Evidence-Based Strategy To Improve Influenza Vaccination Rates Among Registered Nurses In Hospitals, Terri Lynn Spoltore
An Evidence-Based Strategy To Improve Influenza Vaccination Rates Among Registered Nurses In Hospitals, Terri Lynn Spoltore
Walden Dissertations and Doctoral Studies
Seasonal influenza, or the flu, impacts over 3 million people each year. Within the health sector, nosocomial infection and absenteeism are frequently associated with the flu. The Centers for Disease Control and Prevention (CDC) recommend flu vaccination for all eligible individuals, especially health care workers (HCWs). Interventions associated with increased HCW vaccination include educational programs and occupational health campaigns to address misconceptions regarding vaccine safety and efficacy. This project evaluated the impact of a voluntary, web-based education module to encourage registered nurse (RN) vaccination. The logic and health belief models served as the theoretical frameworks. In a nonequivalent group design, …
Nurses' Knowledge Of Pain Assessments And Reassessments Impacts Hospitalized Patients' Reporting Of Pain, M. Michele Potter Williams Williams
Nurses' Knowledge Of Pain Assessments And Reassessments Impacts Hospitalized Patients' Reporting Of Pain, M. Michele Potter Williams Williams
Walden Dissertations and Doctoral Studies
Ineffective pain management can prolong a patient's length of stay and increase cost of care. Inadequate pain control decreases the patient's quality of life and contributes to poor health outcomes. A recent record audit showed that documentation of pain reassessments occurred only 20% of the time within an hour after administering pain medication. Furthermore, nurses may have insufficient knowledge regarding pain assessments and reassessments or hold irrational fears about addiction leading to inadequate treatment of pain. The purpose of this quality improvement project was to evaluate the effectiveness of an educational program for acute care nurses for the assessment and …
Perioperative Orientation, Education, And Mentoring (Poem) Program, Esther M. Johnstone
Perioperative Orientation, Education, And Mentoring (Poem) Program, Esther M. Johnstone
Walden Dissertations and Doctoral Studies
Perioperative registered nurses (RNs) are vital to the provision of safe patient care for those undergoing invasive and surgical procedures within acute care settings. Unrealistic transition-to-practice (T2P) expectations for novice RNs (newly licensed and experienced RNs new to perioperative nursing) have resulted in significant turnover and attrition rates as high as 45%. A T2P program, known as the Perioperative Orientation, Education, and Mentoring (POEM) program, was developed to address attrition and turnover through mentoring and professional development. The POEM program was a pilot program implemented at a large academic medical center. An evaluation tool known as the Surgical Skill Assessment …
Bedside Nurse Recognition Of Delirium In The Medical-Surgical Setting, Bridget Ann Denzik
Bedside Nurse Recognition Of Delirium In The Medical-Surgical Setting, Bridget Ann Denzik
Walden Dissertations and Doctoral Studies
Delirium in adults aged 65 and older is a common occurrence in the acute care setting and is often unrecognized by bedside nurses. Delirium can trigger a negative cascade of events resulting in an increase in morbidity and mortality, functional decline, longer length of stay, and high rates of post hospital institutionalization and has a significant socioeconomic impact. The purpose of this quality improvement project was to establish a solid foundation using scholarly literature to support the development of a delirium prevention, recognition, and treatment program in the medical-surgical acute care setting applying the program logic framework. The goal was …
Development Of A Bedside Shift Report Policy And Guidelines To Assist Nurses With Patient Care, Cynthia Snedecor
Development Of A Bedside Shift Report Policy And Guidelines To Assist Nurses With Patient Care, Cynthia Snedecor
Walden Dissertations and Doctoral Studies
In 2013, the Hospital Consumer Assessment of Healthcare Providers System (HCAHPS), a national, independent metric of patient satisfaction, revealed room for improvement at a teaching hospital in the southeastern section of the United States. This project reports the development and validation of a Bedside Shift Report (BSR) policy, practice guidelines, and associated documentation. Several initiatives, models, and theories informed thinking about this project. The work of Kurt Lewin and the Institute for Healthcare Improvement- Robert Wood Johnson Foundation's joint initiative, Transforming Care at the Bedside, both guided the project in terms of the process of institutional change. SBAR (Situation Background …
Identifying The Beliefs And Barriers To Mammography In Rural African Women, Linda Harper Mangum
Identifying The Beliefs And Barriers To Mammography In Rural African Women, Linda Harper Mangum
Walden Dissertations and Doctoral Studies
Breast cancer is the most commonly diagnosed cancer in African-American (AA) women and is the second leading cause of cancer-related deaths in the United States among AA women ages 40 to 55 years of age. The 5-year breast cancer survival rates for AA women (78%) are lower than are those of Caucasian women (90%). The purpose of this project was to describe the benefits and barriers toward screening mammograms for breast cancer in AA women living in the Southside Health District in Virginia. The subscales of The Champion's Mammography Beliefs and Attitudes Questionnaire (MBAQ, 1999), which is based on the …